If we can define Design Thinking as a way to adopt the mindset of a designer in solving complex problems, then we can also say that Group Thinking might be the antithesis of such a mindset. The late Sumantra Ghoshal described the limitations to innovation in large, complex organisations - he called this "the 4Cs: Compliance; Constraint; Contract; and, Control". You can see how commercial and public sector managers and professionals complain on a regular basis about being held back by 'bureaucracy' or 'paperwork', where the 4Cs are clearly at play, and often, overplayed.
What To Do
In large organisations, Compliance can mean another 'C': conformity. And here is where we see the most negative aspects of Group Thinking: the herd unquestioning and unchallenging status quo. Does this explain why very large enterprises (such as Carillion in UK) go bankrupt, where no one is willing to 'raise a red flag' or as the Hans Christian Andersen fable goes, suggest that 'the emperor may be naked'?
Although you cannot easily change the culture of large commercial or public sector organisation, there are many things you can do to effect positive change and increase employee motivation and engagement. The best way to defeat Group Thinking and the inherent barriers of the 4Cs is to adopt Design Thinking at any level of the organisation. Business thinkers have provided great insights into what should be done to redefine an organisation for the better. A good example is The Individualized Corporation written by Sumantra Ghoshal and Christopher A Bartlett in 1995:
"The image of the 'Organization Man' as a cog in a corporate machine has become both dated and dangerous. Rather than try to force employees into a homogeneous corporate mould based on a company's strategy, structure, and system, world-renowned scholars and consultants Sumantra Ghoshal and Christopher Bartlett argue that managers must embrace a philosophy based on purpose, process, and people that focuses on developing and leveraging the individual's unique talents and skills--a company's most important source of competitive advantage."
This work referenced above was published nearly a quarter of a century ago, and yet today, we still see individuality discouraged in large organisations. The problem with business schools is often a focus on the what, paying insufficient attention paid to the how, in relation to applying transformation of organisational culture and behaviours. This is where I see Design Thinking achieving real change and defeating the worst of Group Thinking in large organisations.
How To Do It
Design Thinking, as a 5-step method defined by the Hasso Plattner Institute of Design at Stanford University (d.school), allows for a simple, pragmatic way to embrace the individuality talked about in 1995 in The Individualized Corporation. Let's take a very challenging example of an environment that everyone recognises needs changing for the better: integrated health and social care.
In recent years I have been exposed to the challenges of integrating health and social care - creating a bridge between patient discharge from a National Health Service (NHS) hospital to a more timely and coherent transfer to post-hospital care at home. For the majority of patients this was post-hospital care funded by local government and delivered by private care agencies. As in commercial business organisations, the customer here - often an elderly citizen - suffers from the consequences of disconnected silos - the NHS Trust, local government social care department and private care agency - all operating in isolation of each other.
As with any Design Thinking applied to solving complex problems, we must create high-levels of trust with all stakeholders. Trust comes from building rapport among people. In this case it was among stakeholders from the NHS Trust, local government and private care agencies in a particular region of UK. And in turn, rapport has to come from receptivity between people - open, frank conversations. This is where the first step in the 5-step Design Thinking methods applies - Empathize, - and before progressing through the subsequent steps of Define; Ideate; Prototype; and, Test.
What I saw initially in each of the health and social care silos of NHS Trust, local government and private care agencies was a lack of trust - mostly due to having little understanding of each stakeholder or the others, and because no vehicle readily exists to bring people together across this care value chain. So, here we are, 27 years after the World Wide Web was launched, and we still have no electronic connection between discharge nurses in hospitals, social care assessors in local government and registered managers in care agencies. Backward? Absolutely. Easy to fix? Technically, yes - culturally, no.
As shown in the infographic above, integrating health and social care is, rather like in automotive manufacturing, a supply chain coordination challenge - a value chain moving from left to right, as a journey from hospital discharge (managed by a hospital discharge nurse) through social care assessment (managed by a local government social worker) to provision of care at home (managed by a care agency manager and delivered by a social carer).
From a NHS perspective, going faster with patient discharge means reducing bed-blocking, from a local government perspective, social care assessments always result in requirements exceeding funding - so there was a compelling need to find better ways to achieve post-hospital patient wellbeing against a backdrop of ever-smaller budgets.
The Empathize step with health and social care stakeholders was accomplished through an activity called Empathy Mapping. This is where a series of workshops and one-to-one interviews draw-out truthful insights from stakeholders engaged in a particular process or set of tasks.
For the health and social care challenge, I invited the key stakeholders into workshops to open-up on the discharge process and explained why we were taking up their very valuable time as health and social care professionals. As illustrated in the left-hand side of the infographic above, I divided a white board into four quadrants and invited each stakeholder (nurse) to write down answers to questions on 'post-it; notes and to place them into the categories of Say, Do, Think and Feel:
Say = Quotes and defining words or phrases.
Do = Actions and behaviours.
Think = Thoughts and beliefs.
Feel = Feelings and emotions.
By getting stakeholders to talk about and write-down their observations (Say, Do) and inferences (Think, Feel), I was able to uncover and validate a much deeper insight into the problem in hand - e.g. hospital bed-blocking or social care budget versus needs. From a Design Thinking perspective, a measurably more substantial Empathize step led to an equally more fruitful process, as we progressed through the steps of Define, Ideate, Prototype; and then, Test - in creating a digital solution for the health and social care problem.
As shown in the infographic above, the findings from Empathy Mapping can be unpacked and categorised by User type - e.g. a nurse or social worker or agency administrator - and get them to write down what they see as their Needs and Insights related to each challenge, process or task.
Think of this as: User ________ Needs ________________ because _____________ (Insights)
As we unpacked the findings from Empathy Mapping and considered Needs and Insights per User, some surprising things emerged. For example, when considering post-hospital social care at home for say, elderly patients, the idea of 'social prescribing' came to the fore: effectively, substituting traditional care services with activities, such as craft work, was considered a better way to invest part of the constrained social care budgets. In turn, this led to challenging the fundamental way in which post-hospital discharge and social care assessments could, and should be made.
To avoid Group Thinking, the Empathy Mapping sessions were conducted in a relaxed atmosphere, where stakeholders felt comfortable to speak out, be frank and freely express their points of view. By using a structured Empathy Mapping process, yet operate with an informal, friendly atmosphere, I was able to gain powerful insights, without consensus diluting individual opinions or ideas - and crucially - where differences were encouraged, and full discussed among all stakeholders.
In unpacking the Empathy Maps from one set of stakeholders (e.g. discharge nurses) to another (e.g. social workers), I could see that having follow-on workshops to explore both the similarities and differences in points of view or even language would reveal key understandings about the barriers between a hospital, local government, care agency - and the citizen at the centre of the entire value chain. This is where each stakeholder learned to better understand and empathize other stakeholders from different organisations in the care value chain.
With Empathy Mapping and deeper insights gained, I was able to move in a more assured way through the next four steps of Design Thinking, as illustrated in the infographic above. This is where stakeholders from all of the organisational silos provided an ongoing engagement in the subsequent steps, resulting in the creation of a new digital solution: The Social Care Platform.
When To Do It
Design Thinking is executed in 5-steps, iteratively: Empathize; Define; Ideate; Prototype; and, Test. An agile, iterative approach to moving through the steps beyond an initial Empathize phase should embrace rapid moves: fail fast; try this - try that. Experimentation through iterative Design Thinking cycles can also enable a complex problem - such as the health and social care integration example noted above - to be broken down into smaller, less risky endeavours.
In going through the iterative cycles of Design Thinking steps it is key to maintain continuous user feedback, thereby achieving high-levels of stakeholder commitment throughout each business engagement. This is where a User Feedback Grid (as illustrated in the infographic above) can be used to create a complete record of the process - and where a new Design Thinking tool called XCELD applies (launching early-2019).
In summary, if thinking about when to do it (Design Thinking, applied) - do it early and do it often.
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